50D2169394 CLIA NUMBER - SPOKANE ORAL SURGERY

Laboratory Demographics

  • CLIA Code: 50D2169394
  • Facility Name: SPOKANE ORAL SURGERY
  • Facility Address: 9911 N NEVADA ST STE 120
    SPOKANE, WA
    ZIP 99218
  • Facility Phone: 509 242-3336
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: TERRANCE HAUCK
  • NPI Number: 1881065076
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 50D2169394
LAB Type Ambulatory Surgery Center
Facility Name SPOKANE ORAL SURGERY
Street 9911 N NEVADA ST STE 120
City SPOKANE
State WA
ZIP 99218
Phone 509 242-3336
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/18/2019
Certificate Expiration Date 4/4/2028
Facility Type Ambulatory Surgery Center
Lab Director TERRANCE HAUCK

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This page was last updated on: 9/29/2025